Voicetrainer Blog

New GERD Guildelines are Easier to Follow

Posted on August 22, 2013 in Medicine for the Voice

New GERD Guidelines are Easier to Swallow

The American College of Gastroenterology has now recommended emphasizing lifestyle strategies to manage reflux (GERD = gastroesophageal reflux disease).   Symptoms can include heartburn, regurgitation, chest pain and difficulty swallowing.  GERD is a separate entity from laryngopharyngeal reflux (LPR) which impacts the throat causing hoarseness for example, but some of the treatment considerations are the same.  

3 key lifestyle modifications are recommended as a first approach to treating GERD:

  • Lose weight if you are overweight or recently gained weight.

  • Elevate the head of your bed 6-8” at night with blocks or a foam wedge if you suffer from night-time GERD.

  • Avoid high-fat meals within 2-3 hours of bedtime and lying down.            

Wide-ranging dietary restriction are no longer recommended, such as eliminating alcohol, caffeine, citrus, and spicy foods, as there is no research showing benefit.   Now, experts encourage you to identify your particular reflux triggers, and modify accordingly.  

If these lifestyle recommendations do not resolve the GERD symptoms, H2 blockers, antacids, and proton pump inhibitors (PPIs) are then introduced.  

  • Over the counter and prescription H2 blockers reduce acid production and provide temporary relief (Pepcid, Zantac, etc.).  

  • Antacids neutralize stomach acid and relieve mild symptoms (Maalox, Mylanta, Alka-Seltzer, etc.).  PPIs are the most effective at healing esophageal inflammation and heartburn relief (Prevacid, Prilosec, Nexium, Dexilant, etc.).  

  • PPIs should be taken 30-60 minutes before meals.  The ACG also notes PPIs are now considered safe for persons with osteoporosis.  

Surgery is reserved only for people with chronic GERD who cannot tolerate the medications.  Persons who do not respond to PPIs are unlikely to respond to surgery per the American College of Gastroenterology.  

Subscribe to RSS
Archives